Theodore Arthur Hubbart, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

172082 Issued in AK

Practice address

812 Renaissance Pointe Apt 107
Altamonte Springs, FL 32714-3526

Phone

(407) 301-0448

NPI assigned

Mar 6, 2021

Last updated

Mar 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1568057099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 RENAISSANCE POINTE APT 107",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143526",
            "telephone_number": "407-301-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 RENAISSANCE POINTE APT 107",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143526",
            "telephone_number": "407-301-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBART",
        "first_name": "THEODORE",
        "middle_name": "ARTHUR",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5197492",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "172082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.